Organization
JOSEPH M MOLINA MD PROFESSIONAL CORPORATION SOUTHERN CALIFORNIA
Active
Parent organization
MEDVANTX, INC.
Other names
Molina Colton
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
1181 N MOUNT VERNON AVE, COLTON, CA 92324-2574
(909) 498-2356
Mailing address
9276 SCRANTON RD, SUITE 100, SAN DIEGO, CA 92121-7701
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
11606
CA
Other
Enumeration date
05/04/2015
Last updated
06/02/2016
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